IBRAHIM MAKHDOOM MD
NPI 1396548996
Student in an Organized Health Care Education/Training Program in Derby, CT
About Ibrahim Makhdoom Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IBRAHIM MAKHDOOM MD (NPI 1396548996) is an individual student in an organized health care education/training program in Derby, Connecticut and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ibrahim Makhdoom Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DERBY, CT 06418
DERBY, CT 06418
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ibrahim Makhdoom's NPI number?
The NPI number for Ibrahim Makhdoom is 1396548996. It was assigned to this individual provider in the NPPES registry on March 29, 2025.
Where is Ibrahim Makhdoom located?
Ibrahim Makhdoom practices at 130 Division St, Derby, CT 06418. The listed phone number is (203) 732-7327.
What is Ibrahim Makhdoom's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Ibrahim Makhdoom enrolled in Medicare?
Yes. Ibrahim Makhdoom is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Ibrahim Makhdoom was last updated on April 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ibrahim Makhdoom, MD · NPI 1396548996
Student in an Organized Health Care Education/Training Program provider in Derby, Connecticut. Individual provider, active in the CMS NPPES registry since March 29, 2025.
## Identity
- **NPI:** 1396548996 (Entity type: Individual)
- **Enumerated:** March 29, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 130 DIVISION ST, Derby, CT 06418-1326
- **Phone:** (203) 732-7327
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 20, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1396548996) · Data from the CMS NPPES public registry.